Women's Health Commons^™

Linking Reproductive Health To Social Power: Community Health Workers In Belize And Pakistan, Susana Galdos, Lucella Campbell, Patricia Mohammed, Debbie Rogow, Saumya Ramarao, Ali M. Mir, Nicole Haberland

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité focuses on two traditional family planning programs that undertook projects to help women enlarge their zone of influence in both the private and public spheres. The first case study focuses on the Belize Family Life Association (BFLA), a nongovernmental organization in a small Caribbean country. The second case study recounts the experience of the Pakistani government, which has an enormous, but entrenched, target-oriented family planning program. Both programs began by recognizing that women’s lack of social power is a major obstacle to their being able to protect their own health. Both trained village workers to regard …

Experience From A Community-Based Education Program In Burkina Faso: The Tostan Program, Djingri Ouoba, Zakari Congo, Nafissatou J. Diop, Molly Melching, Baya Banza, Georges Guiella, Inge Baumgarten

Reproductive Health

This study describes a project that tested the feasibility and effectiveness of replicating the village empowerment program (VEP) developed by the Senegalese NGO, TOSTAN, in Burkina Faso. Although originally developed for empowering women, the program implemented in Burkina Faso also involved men because of their key role in such decisions. Frontiers in Reproductive Health, with funding from USAID and the GTZ Supra Regional Project for the Elimination of FGC, supported the adaptation, implementation, and evaluation of the VEP model in 23 villages in the province of Bazega/Zoundwéogo. In the existing social climate among the Burkinabé, where there is widespread awareness …

The Tostan Program: Evaluation Of A Community Based Education Program In Senegal, Nafissatou J. Diop, Modou Mbacke Faye, Amadou Moreau, Jacqueline Cabral, Helene Benga, Fatou Cisse, Babacar Mane, Inge Baumgarten, Molly Melching

Reproductive Health

This operations research project evaluated the effect and impact of a basic education program, developed by TOSTAN, a nongovernmental organization based at Thiès, Senegal. The basic education program consisted of four modules: hygiene, problem-solving, women’s health, and human rights. Through these four themes, emphasis was placed on enabling the participants, who were mostly women, to analyze their own situation more effectively and thus find the best solutions for themselves. The GTZ Supra Regional Project for the Elimination of Female Genital Cutting funded implementation of the program in 90 villages in Kolda Region, and the Population Council’s Frontiers in Reproductive Health …

Medicalization Of Female Genital Cutting Among The Abagusii In Nyanza Province, Kenya, Carolyne Njue, Ian Askew

Reproductive Health

This study sought to understand the role that health providers play in the medicalization of female genital cutting (FGC) among the Abagusii community in western Kenya, among whom the practice continues to be almost universal. Interviews with service providers and their clients revealed an overwhelming belief that FGC fulfills a traditional cultural obligation among the Abagusii, and that it limits a woman’s sexual desire and confers respect on girls. New approaches are needed within this community to present FGC as violating human rights and national laws, as well as threatening girls’ and women’s health. The study recommends measures such as …

Female Circumcision In Indonesia. Extent, Implications And Possible Interventions To Uphold Women's Health Rights, Meiwita P. Budiharsana, Lila Amaliah, Budi Utomo

Reproductive Health

In Indonesia, the practice of female circumcision (FC) has long existed, but information concerning where and how it is carried out has been limited. The specific aims of the study conducted by the Population Council Jakarta were to provide research-based information on FC customary practices and their socio-cultural determinants, and if possible, to assess any long-term physical and psychological consequences. Study findings indicate that in general Muslim communities support the continuation of FC practice, because they perceive it as both a societal custom and a religious duty. The report strongly recommends that key donor agencies pressure the Ministry of Health …

Condom Use And Abstinence Among Unmarried Young People In Zimbabwe: Which Strategy, Whose Agenda?, Ravai Marindo, Steve Pearson, John B. Casterline

Poverty, Gender, and Youth

This paper compares the views about abstinence and condom use expressed by young people in Zimbabwe in focus-group discussions with the views underlying national policies and religious and traditional beliefs. Young people’s decisions to adopt one or the other of these risk-reduction strategies may not necessarily indicate genuine individual choices, but rather their deference to adults’ interests as they understand those interests. Policymakers and traditional and Christian leaders promote abstinence as the exclusive strategy for all young people, whereas nongovernmental organizations and the private sector promote condom use. Evidence from the focus-group discussions indicates that adolescents are aware of this …

Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

What About Us? Bringing Infertility Into Reproductive Health Care, Okonofua Friday, Bishakha Datta

Poverty, Gender, and Youth

Infertility is a major reproductive health problem throughout much of the world. Despite the prevalence and seriousness of infertility, the population and reproductive health field has largely neglected this problem. National policies and international donor organizations have been one-sided in their focus on programs designed to prevent unwanted pregnancies. This issue of Quality/Calidad/Qualité, with clinic-based narratives and case reports from India and Nigeria, illustrates what is involved in trying to address the problem of infertility in developing countries. A possible framework for incorporating limited infertility care into a family planning or reproductive health program includes providing education and counseling, preliminary …

Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health

Reproductive Health

The Population Council’s Frontiers in Reproductive Health program, with funding from USAID, organized a consultative meeting on the practice of female genital cutting (FGC) in Nairobi, Kenya in April 2002. The meeting brought together a small group of researchers and program managers who are actively undertaking operations research and systematic program evaluations to review the state of the art concerning intervention research design and measurement issues. The deliberations at this workshop should stimulate interest both in undertaking operations research more routinely when programming anti-FGC activities and in furthering the development and application of research methods appropriate for this subject. Several …

From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan

Poverty, Gender, and Youth

With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …

An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku

Reproductive Health

Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi

Reproductive Health

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Rapport Du Seminaire National [Au Mali] Pour La Definition D'Une Strategie D'Eradication De L'Excision, Population Council

Reproductive Health

This is a report on a workshop for the eradication of female genital mutilation (FGM) held in Bamako, Mali. The workshop presented the results of a literature review on FGM and the actions taken to counter the practice in Mali; provided updates on the activities of six national NGOs working on issues surrounding FGM; and developed a Plan of Action for activities aimed at reducing the practice. The workshop brought together 85 participants, including policy- and decisionmakers from the government, NGOs, and religious groups. The workshop led to the finalization of a national Plan of Action to the Year 2000 …

Integrando La Sexualidad En La Planificación Familiar: La Experiencia De Tres Proyectos De Vih/Ets En América Latina Y El Caribe, Julie Becker, Elizabeth Leitman, Mahmoud F. Fathalla

Poverty, Gender, and Youth

Esta edición de Quality/Calidad/Qualité relata la experiencia de tres asociaciones de planificación familiar afiliadas con la International Planned Parenthood Federation/Western Hemisphere Region que han tratado de incorporar una estrategia de prevención del VIH/SIDA en su esquema de trabajo cotidiano. Se examina cómo BEMFAM/Brasil, ASHONPLAFA/Honduras, y FAMPLAN/Jamaica han logrado una transición hacia una oferta de servicios de planificación familiar más enfocada en los clientes mismos y más explícita en el tratamiento de temas sexuales. En cada uno de los tres países, el personal recibió capacitación especial que no sólo los habilitó para proveer información sobre el VIH/SIDA, sino que también les …

Introducing Sexuality Within Family Planning: The Experience Of Three Hiv/Std Prevention Projects From Latin America And The Caribbean, Julie Becker, Elizabeth Leitman, Mahmoud F. Fathalla

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité relates the experience of three family planning associations affiliated with the International Planned Parenthood Federation/Western Hemisphere Region that have tried to incorporate an HIV/AIDS prevention strategy into their existing family planning programs and services. It examines how BEMFAM/Brazil, ASHONPLAFA/ Honduras, and FAMPLAN/Jamaica have made a transition toward a range of family planning services more focused on the clients themselves and more explicit in the treatment of sexual themes. In each of the three countries, the staff received special training that not only enabled them to provide information on HIV/AIDS, but also helped them adopt a broader …

Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal

Reproductive Health

Until recently the study of sexual behavior, despite being a very important area of human behavior, has remained an untouchable subject. The sensitivity of the subject and difficulties collecting required information discouraged social scientists from venturing into this area of human behavior. However, the advent of AIDS and its rapid spread in India has changed the scenario. Today the study of sexual behavior is an important subject and both national and international agencies, as part of the AIDS control program, are encouraging research on the subject. This paper addresses a totally neglected area, which is sexual coercion within marriage. The …

Behavior And Attitudes Related To The Prevention Of Sexually Transmitted Disease And Unplanned Pregnancy, J. Lee Hoover

Dissertations

A sample of 214 persons was tested to determine the impact of gender role orientation, neuroticism, extraversion, authoritarianism, race, gender, and sexual orientation on attitudes and behavior relevant to the prevention of sexually transmitted disease and unintended pregnancy. Specifically measured was the impact of these factors on attitudes toward the condom as contraceptive, attitudes toward the condom as prophylactic, and reported condom use.

Gender role orientation was measured using the short form of the Bern Sex Role Inventory (BSRI) (Bern, 1978), neuroticism and extraversion were measured using the NEO-Five Factor Inventory (NEO-FFI) (Costa & McCrae, 1992), and authoritarianism was measured …

Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council

Reproductive Health

This clinic-based study of female genital mutilation (FGM) was designed and carried out by the Egypt Fertility Care Society to gather detailed information on the types of FGM practiced in Egypt. The study involved interviews with clinic clients to elicit information about their experience and attitudes concerning FGM, and gynecological examinations by specially trained OB/GYN physicians. In all, 93% of the women in this study were found to have some type of FGM. The study's findings were incorporated in the final report of the 1995 Egyptian Demographic and Health Survey, with the aim of contributing to the scientific understanding of …

Living On A Fault Line: Political Violence Against Women In Algeria, Leila Hessini

Poverty, Gender, and Youth

This study raises three questions to better comprehend the crisis women face in Algeria today: how are the state and the opposition groups addressing and defining women’s contemporary status, what is the link between women’s status and violence against them, and what are the tactics both of resistance and accommodation that Algerian women are using to survive in such a context? Throughout this study, the term “Islamic Fundamentalists” refers to movements and people in Algeria who use the “recovery” of early principles of the Ideal Muslim Community to develop their idea of a future Islamic “social order,” with the ultimate …

Women's Perceptions Of Sexuality In Rural Giza, Hind Khattab

Poverty, Gender, and Youth

This study on sexuality among women in rural Giza, Egypt, is part of a broader project on women's health and reproductive morbidity conducted by the Population Council’s Reproductive Health Working Group. Reproductive tract infections (RTIs) and other ailments associated with reproduction among women in the rural community surveyed suggest that a heavy burden of disease is being borne by women living in underprivileged areas in this region. This research on sexuality has been conducted within a conceptual framework that uses a socio-cultural approach to health and illness. The investigation is an assessment of women's perception of and knowledge about sexuality …

Gente Joven: Un Diálogo Sobre La Sexualidad Con Adolescentes Mexicanos, Magaly Marques, John M. Paxman, Judith Bruce

Poverty, Gender, and Youth

Este número de Quality/Calidad/Qualité relata la experiencia de Gente Joven, un programa de educacion sexual para adolescentes en Mexico. Gente Joven comenzó reconociendo una realidad: que los problemas relativos a la sexualidad no desaparecen por mucho que tratemos de negar su existencia. A través de los años los dirigentes de Gente Joven han aprendido, y siguen aprendiendo, muchas lecciones sobre como diseñar un programa eficaz para adolescentes. En estas páginas ellos comparten algunas de esas experiencias y el epilogo explora con mayor detalle un tema que Gente Joven ha identificado como su próximo gran desafío: una reconsideración del programa desde …

Doing More With Less: The Marie Stopes Clinics In Sierra Leone, Nahid Toubia, Grace Ebun Delano

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité reports on the Marie Stopes Sierra Leone (MSSL) organization which pursues its goals with compassion and ambition, despite seemingly insurmountable economic hardships. MSSL has established a service model that many programs in richer countries should try to imitate. Several particularly important lessons emerged, including: creative, skillful management, well-organized and flexible financial administration, and human motivation and perseverance can enable an organization to overcome financial difficulties; family planning is an integral part of people's reproductive and general health concerns and can dovetail with concern for development in useful and practical ways; men appreciate being involved in the …

Arab Women: A Profile Of Diversity And Change, Nahid Toubia, Amira Bahyeldin, Nadia Hijab, Heba Abdel Latif

Poverty, Gender, and Youth

The status of Arab women is the subject of much speculation, generalization, and stereotyping by those inside and outside the region. The paucity of objective, accessible information makes Arab women one of the least understood social groups. The aim of this book is to help correct misconceptions about Arab women by introducing systematic information for 21 Arab countries. Widely published international statistical data, mostly from the United Nations and the World Bank, were used for the comparisons. These datasets are compiled from country reports, national surveys, and aggregated smaller studies. They are by no means comprehensive or devoid of inaccuracies, …

Arab Women: A Profile Of Diversity And Change [Arabic], Nahid Toubia, Amira Bahyeldin, Nadia Hijab, Heba Abdel Latif

Poverty, Gender, and Youth

The status of Arab women is the subject of much speculation, generalization, and stereotyping by those inside and outside the region. The scarcity of objective, accessible information makes Arab women one of the least understood social groups. The aim of this book is to help correct misconceptions about Arab women by introducing systematic information for 21 Arab countries. Widely published international statistical data, mostly from the United Nations and the World Bank, were used for the comparisons. These datasets are compiled from country reports, national surveys, and aggregated smaller studies. They are by no means comprehensive or devoid of inaccuracies, …

The Development Of Microbicides: A New Method Of Hiv Prevention For Women, Christopher J. Elias, Lori L. Heise

HIV and AIDS

A critical review of current epidemiological trends and social science research demonstrates that there is an urgent need for expanding the range of female-controlled HIV prevention methods. Existing efforts to control the spread of HIV infection primarily through the encouragement of a reduction in the number of sexual partners, widespread condom promotion, and the control of other sexually transmitted infections are inadequate for many of the world's women. Underlying gender power inequities severely limit the ability of many women to protect themselves from HIV infection, especially in the absence of a prevention technology they can use, when necessary, without their …

Gente Joven/Young People: A Dialogue On Sexuality With Adolescents In Mexico, Magaly Marques, John M. Paxman, Judith Bruce

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité describes the experience of one adolescent sexuality program, Gente Joven in Mexico. Gente Joven began by acknowledging reality: that the problems related to teenage sexuality will not go away simply by denying their existence. Along the way Gente Joven learned, and is continuing to learn, many lessons about how to build a successful program for adolescents. Here they share their experiences and the Afterword explores in greater depth one particular issue that Gente Joven has identified as its next major challenge: re-examining their work with young people from a gender perspective.

By And For Women: Involving Women In The Development Of Reproductive Health Care Materials, Valerie J. Hull, Barbara L. Ibrahim, Nadia Farah, Blanca Figueroa, Margaret Winn

Poverty, Gender, and Youth

The studies in this issue of Quality/Calidad/Qualité describe three efforts to involve women in the development of reproductive health care materials in different settings in the developing world. In Cairo, a women's health collective produced a comprehensive reference book for women; in Peru, a woman's group, with the extensive involvement of their nonliterate audience, developed a series of illustrated teaching materials; and in the South Pacific, an all-woman production crew produced three motivation and teaching videos developed in response to the expressed needs of Pacific Island women. Despite contrasts in the characteristics of the intended audiences, the development process, and …